Abstract: 【Abstract】 Objective To evaluate the efficacy and safety of the dexmedetomidine when it works as an adjunctive medication with flurbiprofen in the postoperative analgesia of patients undergoing breast surgery. Methods: 90 patients(ASAI-II) undergoing breast surgeries were randomly divided into three groups. The postoperative analgesia pumps consisted of normal saline and 150mg of flurbiprofen were used in group A, and that consisted of normal saline, 0.02μg/kg/h of dexmedetomidine and 150mg of flurbiprofen were used in group B, and that consisted of normal saline, 0.04μg/kg/h of dexmedetomidine and 150mg of flurbiprofen were used in group C. All the postoperative analgesia pumps were made in 100ml volume. The study recorded heart rate(HR), blood pressure(BP), oxygen saturation(SPO2), respiratory rate(RR), pain levels(VAS assessment) and sedation scores(Ramsay assessment) of the patients at different time-points which are before operations and 2 hr(T1), 4hr(T2), 8hr(T3), 24hr(T4), 48hr(T5) after operations, as well as the incidents of side effects .Results: There was no statistic difference among three groups in the patients’ general conditions. BP and HR in Group A and Group B after surgery were higher than before. BP in Group C after surgery was higher than preoperative ,while it was opposite with HR. The comparison among these three groups in BP and HR had statistic differences. The pain levels within 8hr after operations in Group B and C were lower than Group A(P﹤0.05).The sedation scores within 8hr after operations in Group C was higher than Group A and B(P<0.05).The ratio of nausea and vomiting were highest in Group A. The incidence of hypersomnia could only be observed in Group C. Respiratory depression was not found in all cases. The SPO2 of all patients were above 95%. Conclusion: The use of combination of dexmedetomidine(0.02μg/kg/h) and flurbiprofen in postoperative analgesia can offer a better effect of analgesia and sedation than that of flurbiprofen alone, and relatively decrease the incidence of nausea and vomiting, so it can be used in the postoperative analgesia of breast surgery effectively and safely.

Key words: 【Key words】 Dexmedetomidine , Flurbiprofen, Postoperative analgesia , Breast surgery

摘要： [摘要] 目的 研究右美托咪啶复合氟比洛芬酯在乳腺术后的镇痛作用。方法 选择ASAI-II级90例全麻下行乳腺手术患者，随机分3组：A组（对照组），给予氟比洛芬酯150mg；B组，给予氟比洛芬酯150mg+右美托咪啶0.02μg/kg/h；C组给予氟比洛芬酯150mg+右美托咪啶0.04μg/kg/h，生理盐水稀释至100ml。记录手术前（T0），手术后2h（T1），4h（T2），8h（T3），24h（T4），48h（T5）时的心率（RR）、血压（BP）、血氧饱和度(SPO2)，呼吸（RR），疼痛（VAS评分法）和镇静评分（Ramsay分级法）。并观察术后48h内有无出现恶心、呕吐、头晕、嗜睡、呼吸抑制等不良反应发生情况。 结果 A、B两组术后血压和心率值均较术前高，C组术后血压较术前高，但其心率较术前低，组间两两比较差异有统计学意义( P<0.05)。镇痛VAS评分2h~8h内B、C两组和A组比较有统计学意义，24h~48h三组比较无统计学意义。2~8h镇静Ramsay评分C组与A、B两组比较有统计学意义。A组恶心、呕吐的发生率大于B、C组，C组嗜睡发生率大于A、B两组，但均无统计学意义。结论 0.02μg/kg/h的右美托咪定与氟比洛芬酯可安全有效地应用于乳腺术后镇痛。

关键词: 【关键词】右美托咪啶, 氟比洛芬酯, 术后镇痛, 乳腺手术